9 Jan 2015
Loughborough academic helps produce simple toolkit to support GPs in identifying dementia sufferers
A Loughborough University academic has helped to develop a new system which will aid GPs in deciding whether a patient is suffering from early stage dementia or memory failures that are unlikely to develop into dementia.
Professor Paul Drew and researchers at Sheffield Teaching Hospitals NHS Foundation Trust and the University of Sheffield hope to conduct trials of the toolkit with GPs this year.
Based on a technique called ‘conversation analysis’, Professor Drew believes it will save the NHS money and time, and also reduce stress for patients who experience memory problems but who are not actually in the process of developing dementia.
It is very important for GPs to be able to distinguish between people whose memory problems are due to dementia from those who complain of memory problems but do not have dementia. Memory problems are a very common reason to consult the doctor – but at present about a half of all patients referred to specialist memory clinics turn out to have problems that are not associated with dementia.
Professor Drew, from the School of Social Sciences, said: “The toolkit will be a great help. You will get fewer people who do not have dementia being referred to memory clinics. It will also give GPs more confidence to say to a patient, ‘Many people have the sort of concerns about their memory you’re experiencing, but your memory is actually working well and there are no signs of dementia.’
“We have tried to identify features of a patient’s conversation - cues, if you like - that GPs could look for, to help them decide whether the patient needs to be referred to a memory clinic.
“We have come up with a kind of ‘ready reckoner', some simple signs to look for that will suggest whether or not the patient may have a neurological condition (dementia), and therefore whether or not they need to be referred to the memory clinic.”
“It will make a significant financial difference to the NHS, because each visit to a memory clinic costs upward of £1,000. And it will help take the pressure off the neurologists at clinics that are getting clogged up. In addition, it may provide people with early reassurance about their memory function, rather than causing anxiety likely to be associated with referral to a specialist memory clinic.
“We hope to be able to stage trials with GPs in the coming year.”
Professor Drew and the team from Sheffield*, led by Professor Markus Reuber, are the first in the world to use ‘conversation analysis’ to distinguish between patients who may be in the early stages of dementia and those who are not.
Professor Reuber and his team* had previously used a similar technique to distinguish between epileptic and non-epileptic seizures.
The researchers use video and audio recordings of conversations between patients, carers and doctors to look for subtle changes in the use of language which can show tell-tale signs of early dementia.
Analysis of the recordings revealed that there are two distinct conversational profiles for patients with dementia and those with memory problems unrelated to dementia.
These profiles are based on such features as who is most concerned about their memory (patient or family), patients’ ability to respond to compound questions (i.e. two questions in one), how much they elaborate their answers, repetitiveness and hesitancy in answering, and the frequency with which they respond that they ‘don’t know.’
Dr Daniel Blackburn, Consultant Neurologist at Sheffield Teaching Hospitals NHS Foundation Trust and Honorary Senior Lecturer at the University of Sheffield, said: “Six years ago, one in five patients seen in the memory clinic did not have dementia, but recently this ratio has narrowed to one in two. This increase in the referral of people with memory concerns – but no dementia – may be related to recent UK government initiatives to identify more people with dementia early on in their illness.”
Professor Drew said the findings would help GPs identify which patients need to be referred to specialist memory clinics and reduce the distress of patients who do not suffer with dementia.
Around 800,000 people have been diagnosed with dementia in the UK, and the Alzheimer’s Society predicts the number of sufferers will increase to one million by 2021 and 1.7 million by 2051.